NPIMap

Organization Active NPI

Palmetto Rehabilitation Specialists, LLC

  • Physical Therapist
  • Fort Mill, SC
National Provider Identifier
1003194978
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6502 Issued in SC
Legal business name
PALMETTO REHABILITATION SPECIALISTS, LLC
Practice address
105 Ben Casey Dr Ste 127
Fort Mill, SC 29708-8557
Phone
(803) 802-5855
NPI assigned
Jul 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Bates
Title
Co-Owner
Phone
(803) 802-5855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 6502 SC Primary

Addresses

Primary practice location

105 Ben Casey Dr Ste 127
Fort Mill, SC 29708-8557

Mailing address

105 Ben Casey Dr
Suite 127
Fort Mill, SC 29708-8561
Phone (803) 802-5855

Other practice location 1

1203 Colonial Commons Ct
Lancaster, SC 29720-2210
Phone (803) 286-0041

Other practice location 2

1757 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 389-4685

Other practice location 3

1514 E Alexander Love Hwy
York, SC 29745-7769
Phone (803) 628-2220

Other identifiers 1

IdentifierTypeStateIssuer
GP4586MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Rehabilitation Specialists LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1757 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 329-4685

1514 Alexander Love Hwy E
York, SC 29745
Phone (803) 628-2220

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1003194978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR",
            "address_2": "SUITE 127",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088561",
            "telephone_number": "803-802-5855",
            "fax_number": "803-802-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BEN CASEY DR STE 127",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088557",
            "telephone_number": "803-802-5855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Colonial Commons Ct",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "SC",
            "postal_code": "297202210",
            "country_code": "US",
            "telephone_number": "803-286-0041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1757 Ebenezer Rd",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321101",
            "country_code": "US",
            "telephone_number": "803-389-4685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1514 E Alexander Love Hwy",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "SC",
            "postal_code": "297457769",
            "country_code": "US",
            "telephone_number": "803-628-2220",
            "fax_number": "803-802-5869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PALMETTO REHABILITATION SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "803-802-5855"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4586",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.